Dutch Burn Centre Beverwijk

Admission / first few days

A treatment plan is drawn up once a doctor has established the extent and depth of the burns on admission. This can be adjusted later if necessary.

General condition

The first aim of the treatment team is to bring the patient's general condition up to the required level and maintain it. The injuries are assessed and cared for and the patient is placed under close observation.

Monitoring

Sometimes it is necessary to continuously observe the heartbeat, blood pressure, respiration, blood oxygen levels and temperature. The patient is then connected to the monitor so that the above-mentioned readings can be closely watched both at the bedside and in the team post.

Blood pressure and heart rate

Because the injuries disturb the natural balance in the patient's body, the patient might need extra fluids and medicines to support the heart and restore the balance. This recovery period can last from a few hours to a few days.

Respiration

If breathing problems arise, or threaten to arise, due to inhaling smoke or fire, oxygen is given to make it easier to breathe.

It can also be necessary to have a respirator take over the breathing. A tube from the artificial respirator is then put into the windpipe via the mouth or the nose.

Fluids and water management

Burns damage the skin, which causes fluids to be lost. The larger the wound area, the greater the fluid loss. Because this fluid loss must be replenished, the patient is given one or more infusions (drips) via an infusion needle in a blood vessel through which nutrition and blood as well as fluids can be administered.

Eating and drinking

Depending on the nature of the burns, the patient is not, or hardly, allowed to eat or drink anything at first. One reason for this is because the stomach does not work well after a burn injury. This can be difficult for the patient since fluid loss generally makes him thirsty.

Urine

Because it is important for a patient to maintain a good 'fluid balance' it is not only important to give fluids but also to check how much fluid is leaving the body. The discharge of fluid can be checked by using a urinary catheter, a thin tube that is inserted into the bladder via the urethra.

Fluid balance

Burns can seriously disturb the fluid balance; this can make the patient temporarily look swollen. This can sometimes even mean that the patient cannot or can hardly open his eyes.

The swelling disappears in the early days after the burn injury. To avoid excessive swelling the arms and legs are sometimes raised and the patient is nursed in a half-sitting position in bed.

Taking blood

In order for the treatment to proceed as well as possible it is necessary to check on substances present in the blood. Therefore blood is regularly taken.